Chronic Malnutrition, Breastfeeding, and Ready To Use Supplementary Food in a Guatemalan Maya Town

Ready To Use Therapeutic Food (RUTF) and Ready To Use Supplementary Food (RUSF) have proliferated in recent years to treat acute and chronic malnutrition. Biomedical research has established the efficacy of these products, yet little is known about their actual effectiveness in real world settings. This article reports on an ethnographic study of the acceptance and use of RUSF within households in a rural Maya community in Guatemala (a country with the world's third highest rate of chronic malnutrition). We find a number of surprising obstacles to RUSF effectiveness. There is a strong commitment to breastfeeding (supported by public health messages of local NGOs as well as culturally perceived benefits) that leads to sub-optimal complementary feeding after six months. We also found instances of off-label sharing and confusion over relative nutritional values. We present a framework for maximizing RUSF effectiveness that involves nutritional education, positive peer support, and the framing of the product as a medicine.